Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Hospital death rate study reveals wide variations and stresses importance of Registered Nurses

12.01.2007
Hospital death rates can be reduced by employing more Registered Nurses and the routine use of care maps or protocols, according to a study in the latest UK-based Journal of Advanced Nursing.

A research team from the University of Toronto and the Institute for Clinical Evaluative Sciences in Ontario, Canada, studied 46,993 patients admitted to hospital with heart attacks, stroke, pneumonia and blood poisoning.

They discovered that deaths within 30 days of admission varied considerably between the 75 hospitals in the study – ranging from ten per cent to 28 per cent and averaging just under 17 per cent.

When they added in the survey results from nearly 3,886 nurses at the hospitals - together with official discharge and death rates, population statistics and insurance plan data – they discovered that a number of factors accounted for 45 per cent of the variation in death rates.

“Our research underlines the need for hospitals to look as carefully at staffing structures and care processes as they already do at accurate diagnosis and appropriate and effective interventions” says lead author Dr Ann Tourangeau.

19 variables were examined to gauge their effect on 30-day death rates. Key findings included:

- A ten per cent increase in the proportion of Registered Nurses employed was associated with six fewer deaths per 1000 discharged patients.

- The death rate also went down by nine per 1000 discharged patients when the number of Baccalaureate-prepared (university graduate rather than diploma qualified) nurses went up by ten per cent.

- A ten per cent increase in adequate staffing and resources (as reported by nurses) was associated with 17 fewer deaths per 1,000 discharged patients.

“An important finding of our study was the effect that the routine use of care maps or protocols had on lowering 30-day death rates” adds Dr Tourangeau.

“A ten per cent increase in the use of care maps in hospitals, as reported by nurses, was associated with ten fewer deaths for every 1000 patients.

“Our findings contribute to the mounting evidence that structures and processes in hospital nursing care have an impact on patient mortality and survival. They clearly have implications for hospital management, clinical practice and future research” she adds.

“We specifically recommend greater use of care maps or protocols to guide patient care during their time in hospital. These could be shared, as a matter of good practice, on the Internet and adapted around the world to provide patients with culturally sensitive services.

“Although we were able to identify what caused 45 per cent of the variance in 30-day death rates, more than half of the variance remains unexplained.

“Death rates are a complex issue and nursing care is just one factor that influences survival rates. Future research should look at elements such as access to in-patient and out-patient care, the healthcare environment and the impact of hospital management and leadership on outcomes.”

Data sources for the study included the Ontario Canada Discharge Database for 2002/3, the Ontario Hospital Reporting System 2002/3 and the 2003 Ontario Nurse Survey.

All Ontario teaching and community hospitals in operation during the 2002/3 study period were included. Small hospitals discharging fewer than 100 acute medical patients a year and specialty hospitals not providing care for the four key conditions studied were excluded.

5980 nurses working in medical and combined medical-surgical clinical areas across the study hospitals were surveyed and 65 per cent responded - an average of 52 from each of the 75 study hospitals.

Other study findings included:

- The percentage of Registered Nurses ranged from 36 per cent to 100 per cent, with an average of 66 per cent.

- Full-time nursing staff ranged from 35 and 92 per cent, with an average of 61 per cent.

- Nurses had spent between three and a half and fourteen and a half years on their current clinical unit, with an average of just over eight years.

- On average, 13 per cent were Baccalaureate-prepared (graduate) nurses. This ranged from zero to 62 per cent across the hospitals.

- The use of care maps and protocols varied from 29 per cent to 85 per cent, averaging 63 per cent.

- An average of 40 per cent of nurses felt their staffing and resources were adequate, with figures ranging from 19 to 52 per cent.

“This study provides a valuable insight into the nursing factors associated with the 30-day death rate for four common but serious illnesses and adds to the growing body of evidence linking hospital death rates with nurse staffing levels” says Professor Alison Tierney, Editor-in-Chief of the Journal of Advanced Nursing.

“Its observations about the nursing skill mix and use of care protocols is particularly relevant and we hope that hospitals worldwide will study these findings as they address issues that have relevance to both the international nursing community and hospital care in general.”

Annette Whibley | alfa
Further information:
http://www.journalofadvancednursing.com

More articles from Studies and Analyses:

nachricht Drone vs. truck deliveries: Which create less carbon pollution?
31.05.2017 | University of Washington

nachricht New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

Im Focus: Optoelectronic Inline Measurement – Accurate to the Nanometer

Germany counts high-precision manufacturing processes among its advantages as a location. It’s not just the aerospace and automotive industries that require almost waste-free, high-precision manufacturing to provide an efficient way of testing the shape and orientation tolerances of products. Since current inline measurement technology not yet provides the required accuracy, the Fraunhofer Institute for Laser Technology ILT is collaborating with four renowned industry partners in the INSPIRE project to develop inline sensors with a new accuracy class. Funded by the German Federal Ministry of Education and Research (BMBF), the project is scheduled to run until the end of 2019.

New Manufacturing Technologies for New Products

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

A new technique isolates neuronal activity during memory consolidation

22.06.2017 | Life Sciences

Plant inspiration could lead to flexible electronics

22.06.2017 | Materials Sciences

A rhodium-based catalyst for making organosilicon using less precious metal

22.06.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>